MEDICARE: JESSICA RICHARDS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0701006429	VA
2	101YP2500X	Professional Counselor	0701006429	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760726814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RICHARDS LPC

Provider Business Mailing Address
First Line	:	5215 COLLEY AVE STE 104
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-2166
Country	:	US
Telephone Number	:	757-756-5213
Fax Number	:	757-734-9539

Provider Business Practice Location Address
First Line	:	5215 COLLEY AVE STE 104
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23508-2166
Country	:	US
Telephone Number	:	757-756-5213
Fax Number	:	757-734-9539

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	03/12/2026

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